Growth hormone and insulin like growth factor-1 in patients with heart failure due to dilated cardiomyopathy

The aim of this study was to evaluate the level of growth hormone [GH] and insulin like growth factor-1 [IGF-1] in patients with heart failure due to idiopathic dilated cardiomyopathy to find out if the development or progression of heart failure is associated with a derangement of GH and IGF-1. The study was conducted on 30 patients with congestive heart failure due to dilated cardiomyopathy and 7 normal healthy subjects as a control group. The results revealed a significant increase in the serum levels of GH and a significant low serum IGF-1 and albumin in the patients as compared with the control group. Then, the patients were classified according to the NYHA functional classes into four classes [I, II, III and IV]. Sixteen patients were found in functional class IV. There were no differences in the results of this class and the whole patients group, suggesting that class IV represented the whole patient group studied. The study concluded that the serum levels of GH were increased and the serum levels of IGF-1 were diminished in patients with heart failure due to dilated cardiomyopathy. These abnormalities in GH and IGF-1 may have many etiological factors. Abnormalities of GH/IGF-1 axis might have a role either in the development or the progression of heart failure in dilated cardiomyopathy

Kinetic analysis of drainage time and volume in patients on intermittent peritoneal dialysis

This study was done to examine features of drainage flow and to determine whether the drainage period could be safely reduced in intermittent peritoneal dialysis patients [IPD]. Eight patients were examined in an open nonrandomized prospective study. Drainage flow pattern was measured using 2-L dialysate. The drainage period was reduced from 30 minutes [mean] to 10 minutes throughout the dialysis sitting. Ultrafiltration volume, body weight and peritoneal clearance of urea, creatinine and phosphate as well as the protein loss were measured. A kinetic analysis of the drainage period and volume indicated a positive linear correlation with two different slopes: one for rapid drainage for the first 7 minutes and one for subsequent slow drainage. The effluent exceeded 90 percent in the first 10 minutes. Ultrafiltration volume and body weight showed no change due to the reduction. Most of the patients were satisfied with the reduction and desired its continuation. We can conclude that ten minutes is a sufficient drainage period for most IPD patients with a 2-L dialysate volume. This may possibly allow an increase in effective peritoneal membrane dialysate contact period